Don’t Bet On It – Preventing Teen
Gambling
Cele Fichter DeSando, MPM
Addiction Medicine Services, WPIC, UPMC
1
Today’s Training
Teen Gambling: A Growing Epidemic
2
Today’s Training
• Explore adolescent problem gambling progression and risk and
protective factors
• Define problem and pathological gambling including DSM-V stages and
criteria.
• Identify the prevalence and relationship of problem gambling to alcohol,
tobacco and other substance use as well as psychiatric disorders.
• Provide a survey review of research-based screening/interview tools and
resources for treatment.
• Provide research-based prevention and intervention school and student
assistance program strategies to prevent and delay adolescent problem
gambling.
3
What is Gambling?
Gambling is an activity in which something of value is
risked on the outcome of an event when the
probability of winning and losing is less than certain.
(Korn and Shaffer 1999).
What is Pathological (Disordered)
Gambling?
• Disordered gambling is classified as persistent
and recurrent maladaptive gambling behavior that
disrupts personal, family, or vocational pursuits and is not
better accounted for by a manic episode.
Source: American Psychiatric Association (APA),
Diagnostic and Statistical Manual,
Revision IV – Text Revision (DSM-IV-TR), (APA, 2000).
• Previously categorized as an impulse control disorder but
recently moved to addiction-related disorders in DSM-V
Similarities to Addictions
• In DSM-V – Gambling is listed as addiction related disorder instead of
old classification of impulse control disorder. The rationale for this
change is that the growing body of scientific literature, especially on the
brain’s reward center, has revealed commonalities between pathological
gambling and substance-use disorders.
– Loss of control
– Preoccupation, urges, pathological “wanting”, cravings, associated
“highs”
– Negative impact on major areas of life
– Major impacts on mood. Judgment and insight
– Tolerance/ Withdrawal
– Hereditary nature
– Similar treatment success-12 step and cognitive behavioral therapy
Gambling as Pervasive Recreation
Increasing Opportunities
• Gambling in many different forms has long been a
part of the history of the world
• 48 states have some form of legalized recreational
gambling in the form of Bingo, Lottery, Race Track,
Slots, Poker, Table Games, Sports Betting*
• New Frontier -Online Gambling is widespread, yet
unregulated, technically restricted and under
contention in the US – Regulations change rapidly
– Nevada and New Jersey recently passed
legislation to allow online, while in-state, is PA
next?
*Exception of Utah and Hawaii
Who Gambles?
• 85% of U.S. adults have gambled at least once in
their lifetimes (60% -80% in any given year )
• 3-5% have a gambling disorder.
(The National Council on Problem Gambling, 2010).
• The majority of the population can gamble without negative
consequences
Betting on a Sure Thing
Who has a Problem?
• 1% + are estimated to be pathological gamblers
(PG)
• 2-3% are considered problem or subclinical
gamblers
• Disordered Gambling is a term used to describe the
full range of gambling problems.
Upping the Ante:
Teens and Gambling
• 2.8-8% of Adolescents and college students exhibit
problem and pathological gambling (NORC,1999)
• Student athletes particularly vulnerable
• Affects all races – differences are found in the
types of games played, belief about money,
finances and self worth,
• Disproportionate number of smokers, substances
abusers, mentally ill and poor are problem
gamblers
Vulnerable Populations
• Adolescents
– 5-6% meet criteria
– 8-8% at risk for developing
• Elderly
– Harder to recoup financial losses
• Military – All branches run oversees slots for
recreation and to make money for social events
• Casino Workers
– Chicken or the egg?
• Incarcerated
– #1 pastime is gambling
• Substance Use Disorders
– 6-10x risk for PG
• Lower SES
– Problems develop sooner
How much do
adolescents gamble?
•
•
•
•
•
60-90% have gambled
Similar, internationally
Strong pop culture influences
No monitoring system
Societal, parental acceptance
Reasons for gambling
•
•
•
•
•
•
Win money
Social activity
Excitement
Competition
Fantasy
Family members
Characteristics of Low Risk Gambling
• Low risk gamblers know that over time nearly
everyone loses. The benefit is in the social and
entertainment activity not an expectation of
financial gain.
• Low risk gambling has limits on frequency and
duration.
• Low risk gambling has predetermined, acceptable
limits for losses as in the acceptable and affordable
cost of an entertainment activity.
• Does PA have a gambling problem?
Gambling Ambivalence
Love the Money – Hate the Problems
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Societal Approval and Fallacy
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Gambling and Spending
How much is too much?
• 2002 U.S. legal gaming revenue was $68.7 billion.
• In 1999 the National Gambling Impact Study Commission
estimated the annual cost to society of problem gambling
was $5 billion.
• It is estimated that in 1997 Americans collectively wagered
more than $1/2 trillion (National Research Council, 1999)
• Consumers spend more on legal gaming in the U.S. than
most other forms of entertainment combined (1998 Gross
Annual Wager Report, 1999)
• Sports betting -38 billion legally wagered-380 billion illegal
“Gambling Nation”
• $600 billion wagered annually
• Revenue Comparisons (2005)
–
–
–
–
Gambling (Legal) $83 Billion per year
DVDs: $22 Billion per year
Cigarettes: $19 Billion per year
NIH Annual Budget: $30 Billion per year
(American Gaming Association, CDC, Hollywood Reporter)
Pennsylvania Monthly Casino Gambling – Table games
20
Casino
April
2014
Tables
April 2014
Gross
Revenue
April 2013
Tables
April 2013
Gross
Revenue
Sands Casino Resort Bethlehem
200
$15,028,894
183
$13,932,560
Parx Casino
164
$10,061,363
164
$10,153,193
SugarHouse Casino
62
$7,901,261
58
$7,316,611
Rivers Casino
113
$6,252,232
114
$4,992,447
Harrah's Philadelphia Casino and Racetrack
126
$6,154,439
121
$6,665,016
Mount Airy Casino Resort
80
$4,033,101
72
$3,135,321
Mohegan Sun at Pocono Downs
87
$3,684,368
84
$3,513,736
Valley Forge Casino Resort
50
$3,209,574
50
$2,790,101
Hollywood Casino at Penn National Race Course
73
$2,451,961
69
$3,423,756
The Meadows Racetrack and Casino
77
$1,914,964
80
$4,381,161
Presque Isle Downs and Casino
46
$1,130,264
46
$1,248,432
Lady Luck Casino Nemacolin (opened 7/1/13)
28
$362,370
N/A
N/A
Statewide Total
1,106
$62,184,790
1,041
$61,552,334
Pennsylvania Casino Gambling Slot Machines
Casino
April 2013
% Change
Parx Casino
$30,454,522.24
$31,608,967.66
-3.65%
Sands Casino Resort Bethlehem
$23,702,187.99
$24,465,867.34
-3.12%
Rivers Casino
$23,152,882.76
$24,444,239.86
-5.28%
Harrah's Philadelphia Casino and Racetrack
$18,668,264.14
$20,618,424.07
-9.46%
Mohegan Sun at Pocono Downs
$18,580,699.98
$18,600,479.48
-0.11%
The Meadows Racetrack and Casino
$18,533,750.02
$20,110,853.72
-7.84%
Hollywood Casino at Penn National Race Course
$18,297,057.66
$20,372,504.80
-10.19%
Sugarhouse Casino
$15,042,414.67
$15,467,112.79
-2.75%
Mount Airy Casino Resort
$12,120,975.73
$12,262,468.51
-1.15%
Presque Isle Downs and Casino
$10,629,226.63
$11,809,262.50
-9.99%
Valley Forge Casino Resort
$6,475,249.53
$5,395,225.16
20.02%
Lady Luck Casino Nemacolin (opened 7/1/13)
$2,103,745.41
Statewide Total
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April 2014
N/A
$197,760,976.76 $205,155,405.89
N/A
-3.60%
PA Casino Amounts Wagered – Gambler’s Fallacy
• Table Games
– 2010-11 - $507,711,162
– 2011-12 - $663,854,672
– 2012-13 - $ 713,107,163
Slots
2006-07 - $ 5,055,282,636
2007-08 - $17,288,615,432
2008/09 - $22,509,815,164
2009/10 - $29,308.239,022
2010/2011 - $29,759,096,846
2011-12 - $ 31,164,547,147
2012-13 - $30,819,486,036
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Of the 23 states with casinos
Name the top three states for gambling revenue
• Nevada 10.860 billion
• Pennsylvania 3.158 billion
• New Jersey 3.051 billion
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Gambling Ambivalence and Distortion
It’s all about the Marketing
Your chances of being murdered 1 in 18,000
Your chances of winning Mega Millions Lottery
1 in 135,145,920
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What are the odds you’ll become a problem
gambler?
• Pathological gambling is hypothesized to be caused by a
complex interplay involving neurobiological, genetic,
psychological and social risk factors. (Shaffer et al. 2004c)
• There is evidence of associations between pathological
gambling and a variety of neurotransmitters (e.g.
noradrenaline, serotonin, glutamate, dopamine and
endorphins); (Potenza 2008).
The Brain and Addiction
Dopamine and Nicotine
Dopamine is a brain chemical involved in many different functions
including movement, motivation, reward and addiction. Altering dopamine levels alters
the normal communication between neurons
Gambling as a Brain Disease
Neurobiology of PG
(Neuroanatomy)
• Potenza’s Imaging Studies (PG vs Normals)
• Decreased activity in:
– Left ventromedial PFC (Decision-making)
– Orbitofrontal cortex (processing of rewards, dealing with
uncertainty, inhibiting responses)
– Anterior Cingulate (Decision-making)
– Ventral striatum (NA, Limbic system)
Are brains of problem
gamblers different?
• Pathological Gamblers exhibit lower activity in
prefrontal cortex compared to Non-PGs
• In performing neuro-cognitive tests, PGs showed
similar dysfunctions in prefrontal cortex as
Methamphetamine addicts
Potenza et
al., 2003
This Is Your Brain on Gambling
fMRI of subject
anticipating a
monetary win in
simulated game
fMRI of subject
anticipating a small
amount of cocaine
Breiter et
al., 2001
Differences from Addictions
– No toxicology test to diagnosis it; easier to hide
– Behaviors are not due to drug effects (thus, makes it more open to
shame/guilt)
– Directly associated with financial gains and losses – accolades and
blame for same behavior
– Greater uncertainty of outcome (i.e. anything can happen)
– Ego related symptoms- gambling can boost ego or cause discord
with self image
– More Socially acceptable
Similarities / Difference
• Immediate gratification
• Addictive: preoccupation,
inability to stop, tolerance &
withdrawal, progressive
• Cravings & urges
• Denial is common
• Accompanying depression /
anxiety
• Blackouts / brownouts
• Disassociation
• Mechanism for escape
• Dysfunctions in the family
often present
• Gambling more hidden
• Impossible to overdose on
gambling
• No ingestion of chemicals
• Labile financial situation
• More unpredictable
outcome
• Generally not perceived as a
disease
• Fewer resources for
gamblers
• Faster progression
DSM-V Workgroup on Gambling Disorder
• Gambling Disorder can be episodic or chronic, and the
course of the disorder can vary by type of gambling as well
as life circumstances (Hodgins and el Guebaly, 2004;
Slutske, 2006). For example, an individual who wagers
problematically only on football games may have Gambling
Disorder during football season and not wager at all, or not
wager problematically, throughout the remainder of the year.
Gambling Disorder may also occur at one or more points in
an individual’s life but be absent during other periods.
Alternately, some individuals experience chronic Gambling
Disorder throughout all or most of their lives.
•
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DSM-V Criteria
• A. Persistent and recurrent problematic gambling
behavior as indicated by four (or more) of the following in a
12-month period:
1.needs to gamble with increasing amounts of money in
order to achieve the desired excitement
2. is restless or irritable when attempting to cut down or
stop gambling
3. has repeated unsuccessful efforts to control, cut
back, or stop gambling
4. is often preoccupied with gambling (e.g., persistent
thoughts of reliving past gambling experiences,
handicapping or planning the next venture, or thinking of
ways to get money with which to gamble)
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DSM-V Criteria
5. gambles often when feeling distressed (e.g., helpless,
guilty, anxious, depressed)
6. after losing money gambling, often returns another day to
get even (“chasing” one’s losses)
7. lies to conceal the extent of involvement with gambling
8. has jeopardized or lost a significant relationship, job, or
educational or career opportunity because of gambling
9. relies on others to provide money to relieve desperate
financial situations caused by gambling
B. The gambling behavior is not better accounted for by a
Manic Episode.
•
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What are problem gamblers looking for?
With all of the negative consequences why continue
to gamble?
• Action – Looking for excitement “rush”
• Escape – Looking for relief from painful emotions or
stress Lesieur and Rosenthal (1991).
Many adolescents think they can become professional
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Action Gamblers
• Gambles for excitement , competition
• More likely to engage in “skilled” forms of gaming.
(sports betting, poker, etc).
• More likely to have early onset of gambling
• Longer progression from regular to out of control
(addicted) gambling
• More likely to be male
• More likely to present narcissistic or antisocial traits
Bragging
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Denial
Fallacy of Skill
Allure Appeals to Action and Escape Gamblers
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Escape Gamblers
• Gambles for relief, escape from stress or negative
affect
• More likely to engage in passive, luck forms of
gambling (Lottery, slots, bingo)
• Shorter progression from regular gambling to out of
control behavior
• More likely to be female
• More likely to be have experienced chronic
depresssion
Escape - Gambling looks like fun – and it is!
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Problem Gambling Progression:
When it stops being fun
• Winning Phase- gamblers experience a big win or
series of wins resulting in unreasonable optimism
or belief in their ability to win.
• Losing Phase-gamblers begin bragging and
thinking about past wins, secretly gambling and
begin to chase their losses.
• Desperation Phase- gambling increases in time,
frequency and amount. Remorse, alienation and
problems increase.
• Hopeless Phase – Gambler no longer believes
there is help or hope. Lesieur and Custer (1984).
Upping the ante: What’s the Problem with
Problem Gambling?
Several studies have documented the relationship
between problem gambling and specific health
issues.
• Mental Health – Gamblers are at increased risk for
major depression, anti-social personality disorder,
phobias and other mental conditions. Problem
gamblers were also identified as being at increased
risk for alcohol, nicotine, and other drug abuse.
Potenza, (2008).
Double or Nothing
• Individuals with mental and/or substance use
disorders are 17 times more likely to develop
pathological gambling
• Pathological Gamblers are 5.5 more likely to have
to have had a substance use disorder (Kessler et
al. 2008)
• 75% of pathological gamblers have had an alcohol
disorder; 38% have had a drug use disorder; 60%
have had nicotine dependency (Petry et al. 2005).
• Recreational Gamblers smoke at same rate as
general population, 60-80% of pathological
gamblers smoke.
The Hidden Vigorish
Genetic and Familial Factors
• Research consistently shows higher rates of
pathological gambling in teens whose parents
gamble too much (Gupta & Derevensky, 1997;
Jacobs, 2000; Wallisch & Liu, 1996)
• Children of problem gamblers have been shown to
have higher levels of use for tobacco, alcohol, drug
use, and overeating than do their classroom peers
(Gupta & Derevensky, 1997)
The Hidden Vigorish
Co-occurring disorders
• In treatment-seeking pathological gamblers, 3276% of patients evidenced other mental health
problems, with anxiety, depression, and suicide
being most common.
• Problem gamblers are 4 times more likely to have
major depression than non-problem gamblers
• Suicide attempt rates are 17% -24% for problem
gamblers (US DHHS,SAMSHA, 2005)
The Hidden Vigorish
• Gambling problems may be major impediments to
recovery and contributors to relapse in mental
health and substance abuse disorders.
Beating the System- Hedge Your Bets
• Mental Health, Substance Abuse and Primary Care
Professionals and school professionals can help
identify, intervene, and refer/treat problem
gamblers.
• Treatment and intervention can be incorporated
into existing substance abuse and mental health
programs.
What are the Odds?
Risk Factors Marotta and Hynes (2003)
• Early onset of gambling experiences/early win
• Biochemical factors associated with increased
physiological resting state, increased sensation
seeking, increased arousal during gambling.
• Depression
• Poor Coping Skills
• Substance Use/Abuse
Risk Factors for Gambling Problems
• Accessibility/Awareness*
• Lack of community awareness of dangers
• Social Acceptance
• Family History of Addiction and/or illegal activity
• Competitive Home Environment
• Family History of gambling activity and attitudes.
• Poor Impulse Control
*There is much discussion as to the extent of accessibility leading to risk and there
are theories related to exposure and adaptation (Shaffer and Martin) 2010.
Teen Gambling by Derevensky
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Risk Factors for Adolescents
• Despite not being of legal age to gamble on regulated
forms of gambling, adolescents are at risk for developing
gambling problems (Derevensky & Gupta, 2004; Dickson,
Derevensky & Gupta, 2004; Jacobs, 2004; National Research Council,
1999; Shaffer & Hall, 1996; Shaffer, Hall & Vander Bilt, 1999).
• Early research suggests adolescents perceive their
parents to generally approve of their gambling, are not
concerned about getting caught gambling, and report
that gambling with family members is a fairly common
occurrence (Gupta & Derevensky, 1997; Ladouceur & Mireault, 1988;
Moore & Ohtsuka, 1997).
Our current state of knowledge
concerning youth gambling problems….
• Gambling is more popular amongst males than
females (Derevensky, Gupta & Della Cioppa, 1996; Fisher, 1990;
Govoni, Rupcich, & Frisch, 1996; Griffiths, 1989; Gupta & Derevensky,
1998a; Jacobs, 2000; Ladouceur et al., 1994; NORC, 1999; NRC,
1999; Stinchfield, Cassuto, Winters, & Latimer, 1997; Volberg, 1994,
1996, 1998; Wynne et al., 1996)
• Probable pathological gamblers are greater risktakers (Arnett; 1994; Breen & Zuckerman, 1996; Derevensky &
Gupta, 1996; Nower, Derevensky & Gupta, 2000; Powell, Hardoon,
Derevensky, & Gupta 1999; Zuckerman, 1979, 1994; Zuckerman,
Eysenck, & Eysenck, 1978)
• Adolescent prevalence rates of problem gamblers are
2-4 times that of adults (Gupta & Derevensky, 1998a; Jacobs,
2000; Shaffer & Hall, 1996)
Teen Gambling
57
• Adolescent pathological gamblers have lower self
esteem compared with other adolescents (Gupta &
Derevensky, 1998b)
• Adolescent problem gamblers have higher rates of
depression (Gupta & Derevensky, 1998a,1998b; Marget, Gupta &
Derevensky, 1999; Nower, Derevensky & Gupta, 2000)
• Adolescent problem gamblers dissociate more
frequently when gambling (Gupta & Derevensky, 1998b;
Jacobs, Marsten & Singer, 1985)
• Adolescents with gambling problems, ages 14-17,
are at heightened risk for suicide ideation and suicide
attempts (Gupta & Derevensky, 1998a)
• While adolescents with gambling problems report
having a support group, old friends are often replaced
by gambling associates (Derevensky, 1999; Gupta, 1999;
Gupta & Derevensky, 2000)
• Adolescent problem gamblers remain at increased
risk for the development of an addiction or
polyaddictions (Gupta & Derevensky,1998a,1998b; Kusyszyn,
1972; Lesieur & Klein, 1987; Nower, Derevensky & Gupta, 2000;
Winters & Anderson, 2000)
• Adolescent problem gamblers score higher on
excitability, extroversion, and anxiety & lower on
conformity and self-discipline (Gupta & Derevensky,
1997b,1998a; Vitaro, Ferland, Jacques & Ladouceur, 1998)
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• Pathological gamblers and youth in general report
early gambling in the home and with family members
(Derevensky & Gupta, 1997; Gupta & Derevensky, 1997a, 1997b)
• Problem and pathological gambling has been shown
to result in increased delinquency and crime,
disruption of familial relationships and decreased
academic performance (Gupta & Derevensky, 1998a;
Ladouceur & Mireault, 1988; Lesieur & Klein, 1987; Wynne et al., 1996)
• Pathological gamblers report greater major and minor
life stressors (Gupta & Derevensky, 2002; Kaufman, Gupta &
Derevensky, 2002)
• Problem and pathological gambling has been shown
to have greater levels of trait and state anxiety (SteMarie, Gupta & Derevensky, 2002)
Using schools as a basis for prevention through
promotion of social/personal competence
(Haggerty, Sherrod, Garmezy, & Rutter, 1994)
at-risk vs. general population
target appropriate age groups with
developmentally appropriate interventions
focus not merely on gambling but on social skills,
coping abilities, & problem solving skills
Profile of the Adolescent Problem Gambler
(Derevensky, 2010)
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•
•
•
•
•
Predominantly Male
Significant anxiety
Familial problems
Poor peer relationships
Preoccupation with gambling – repeated attempts to stop
Different forms of gambling sports betting, online, cards,
dice
• Serious financial difficulties
• Failure in school/work
• Lying to family friends
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Profile cont.
•
•
•
•
•
•
•
65
Friends usually have similar gambling problems
Stealing from family, friends, stores etc
Depression or feeling dead inside
Gambling to escape and feel better
General lack of coping abilities
Confused and conflicted about whether to stop or cut down
Need for arousal or strong sensations (possible ADHD)
What gambling activities do teens do?
• Card Playing for money
• Betting on activities for money
• Sports betting, sports pools
• Online gambling – Internet for $ and Internet no $
• Lottery/Scratch off tickets
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Internet Gambling Risks
• 4 A’s
• Anyone (Anonymity)
• Any Age (No ability to check age – sites prompt underage
users)
• Anytime ( Accessibility 24/7)
• Anywhere (Availability – Work, Home, Online, Mobile)
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Internet problems – more research needed
69
Escape Allure
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Action – Learn the Skill
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Buddy Bet – Betting on Anything
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Social media
• What is BuddyBet?
• BuddyBet is a social betting site -- one that lets you match
wits with living, breathing, communicating people rather than
geeky gambling experts and their supercomputers. In short,
people bet against each other on BuddyBet rather than
against the website itself. You set your own odds and
choose your own Betting for BuddyBucks
• If you'd rather not bet for cash or for actions/forfeits, you can
bet for fun (and pride) using BuddyBucks, BuddyBet's virtual
currency.
73
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Acceptance and Availability
75
76
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Online Gaming
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Online Gambling is PA Next?
79
Online gaming is PA next?
80
Don’t Bet on It
• Substance Abuse Counselors and Student
Assistance Professionals are very well poised to
offer identification and help with gambling problems
based on understanding of addictions and the link
between the disorders.
However:
• Substance Abuse and Mental Health counselors
cannot assume knowledge of gambling and must
learn the similarities/ differences, language and
specifics of gambling , specific screening and
treatment tools and resources for help.
Using schools as a basis for prevention through
promotion of social/personal competence
(Haggerty, Sherrod, Garmezy, & Rutter, 1994)
at-risk vs. general population
target appropriate age groups with
developmentally appropriate interventions
focus not merely on gambling but on social skills,
coping abilities, & problem solving skills
Gambling Prevention
Prevention through risk-reduction
–
–
–
–
individual
family
peer and social contexts
community context
• Risk-reduction by enhancing protective factors
– attributes of the individual
– family support
– environmental support
• Using schools as a basis for prevention through
promotion of social/personal competence (Haggerty,
Sherrod, Garmezy, & Rutter, 1994
Responsible prevention efforts include...
 Incorporating knowledge acquired from scientific
research
 Taking a wide-angled approach (multi-faceted)
 Adjusting the material to the developmental level
of the recipient
 Testing for program effectiveness PRIOR to
widespread implementation
 Conducting focus groups with teachers and
children for input on program development and to
evaluate teacher willingness to implement the
prevention format
A Winning Program
• Use evidenced based prevention,assessment and
treatments and existing supports such as gamblers
anonymous
• Include gambling screen/questions in student
assistance and mental health and substance abuse
assessments
• Include a comprehensive risk assessment
(suicide/harm to others)
• Offer multi-model approach to include, legal
financial and family issues
• Keep updated on gambling research
References
• Am. Psychiatr. Assoc. 2000. Diagnostic and Statistical Manual of
Mental Disorders, Fourth Edition, Text Revision. Washington, DC:
Am. Psychiatr. Assoc.
• Am. Psychiatr. Assoc. 2010. 312.31 Pathological Gambling. In
Proposed Draft Revisions to DSM Disorders and Criteria,
Arlington. VA: Am Psychiatr. Assoc.
• 1998 Gross Annual Wager Report. International Gaming and
Business Wagering (IGBW) Trade Magazine. (1999, August).
Retrieved 2/21/02, from
http://biz.yahoo.com/prnews/990803/ny_igwb_wa_1.html
• Gupta, R., & Derevensky, J.L. (1997). Familial and social
influences on juvenile gambling behavior. Journal of Gambling
Studies, 13(3), 179-192.
• Kessler RC, Hwang I, LaBrie RA, Petukhova M, Sampson N, et
al. 2008. DSM-IV pathological gambling in the National
Comorbidity Survey Replication. Psychol. Med. 38:1351-60
References (cont.)
•
•
•
•
•
Korn, DA, Shaffer HJ. 1999. Gambling and the health of the public: adopting a
public health perspective. J.Gambl, Stud. 15:289-365
Lesieur HR, Coster RL. 1984. Pathological Gambling: Roots, Phases and
Treatment. The ANNALS of the American Academy of Political and Social
Science, 474:146-156
Lesieur HR, Rosenthal RJ. 1991. Pathological gambling: a review of the
literature (prepared for the American Psychiatric Association Task Force on
DSM-IV Committee on Disorders of Impulse Control Not Elsewhere Classified).
J. Gambl. Stud. 7:5-39
Natl. Counc. Problem Gambl. 2010. What is problem gambling?
http://www.ncpgambling.org/i4a/pages/index.cfm?pageid=1
National Opinion Research Center (NORC). (1999). Gambling Impact and
Behavior Study, Report to the National Gambling Impact Study Commission
[Electronic Version]. Chicago, IL: Author.
References (cont.)
•
•
•
•
National Problem Gambling Awareness Week. 2011 Problem Gambling
Information: Facts and Figures.
http://www.npgaw.org/problemgamblinginformation/factsfigures.asp
National Research Council (NRC). (1999). Pathological Gambling: A Critical
Review. Washington, D.C.: National Academy Press.
Petry NM, Stinson FS, Grant BF. 2005. Comorbidity of DSM-14 pathological
gambling and other psychiatric disorders: results from the National
Epidemiologic Survey on Alcohol and Related Conditions. J. Clin. Psychiatry
66:564-74
Potenza M. 2008. The neurobiology of pathological gambling and drug addiction:
an overview and new findings. Philos. Trans. R. Soc. 363:3181-89
References (cont.)
• Shaffer HJ, LaPlante DA, LaBrie RA, Kidman R, Donato A, Stanton M.
2004c. Toward a syndrome model of addiction: multiple expressions,
common etiology. Harv. Rev. Psychiatry 12:367-74
• Shaffer HJ, Martin R. 2010. Disorders & Gambling: Etiology, Trajectory
and Clinical Consideration. Annual Review of Clinical Psychology. 2011
• Thompson, W., Gazel, R., Rickman, D. (1996). The social cost of
gambling in Wisconsin. Wisconsin Policy Research Institute Report, 9,
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References (cont.)
• Unwin, B.K., Davis, M.K., & Leeuw, J.B. (2000). Pathological gambling.
American Family Physician, February 2000, 61, 741-749.
• US Dept of Health & Human Services, SAMHSA, Substance Abuse
Treatment for Co-Occurring Disorders Publication No. 05-3992,2005
• Wallisch, L., & Liu, L. (1996). Drug use and gambling behavior among
adults and youths in Texas: Survey findings. In: Epidemiologic Trends in
Drug Abuse. Rockville, MD: National Institute on Drug Abuse. Volume II:
433-457.
Web Resources for A Winning Program
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http://www.addictionrecov.org
http://www.ncpgambling.org
http://www.gamblersanonymous.org
http://www.ncrg.org
http://mayoclinic.com/invoke.cfm?id=DS00443
http://www.abgaminginstitute.ualberta.ca
http://www.npgaw.org/